NPIMap

Organization Active NPI

Rose Family Dental

  • Dentist
  • Battle Ground, WA
National Provider Identifier
1710109210
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7107 Issued in WA
Legal business name
ROSE FAMILY DENTAL
Practice address
15 SW 20TH Avenue
Battle Ground, WA 98604
Phone
(360) 687-5665
Fax
(360) 687-5053
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Karl David Rose, DDS
Title
Dentist
Phone
(360) 687-5665

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 9791 WA
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 4539 WA
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 7107 WA Primary

Addresses

Primary practice location

15 SW 20TH Avenue
Battle Ground, WA 98604

Mailing address

PO Box 157
15 SW 20TH Avenue
Battle Ground, WA 98604
Phone (360) 687-5665

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1710109210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 157",
            "address_2": "15 SW 20TH AVENUE",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "98604",
            "telephone_number": "360-687-5665",
            "fax_number": "360-687-5053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SW 20TH AVENUE",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "98604",
            "telephone_number": "360-687-5665",
            "fax_number": "360-687-5053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSE FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "KARL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "360-687-5665",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "9791",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "4539",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "7107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Ground, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.